Peng Yu-Ting, Yu Ren-Tao, Chen Ai-Jun, Wen Zhu-Yuan, Xu Jing, Huang Kun, Wang Ping
Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Diagnostics (Basel). 2023 Feb 8;13(4):633. doi: 10.3390/diagnostics13040633.
Nail involvement has a tremendous impact on psoriasis patients. Early detection and prompt intervention of psoriatic nail damage are necessary.
A total of 4290 patients confirmed to have psoriasis between June 2020 and September 2021 were recruited from the Follow-up Study of Psoriasis database. Among them, 3920 patients were selected and divided into the nail involvement group ( = 929) and the non-nail involvement group ( = 2991) by inclusion and exclusion criteria. Univariate and multivariable logistic regression analyses were performed to identify the predictors of nail involvement for the nomogram. Calibration plots, the receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the discriminative and calibrating ability and clinical utility of the nomogram.
Sex, age at onset, duration, smoking, drug allergy history, comorbidity, sub-type of psoriasis, scalp involvement, palmoplantar involvement, genital involvement, and PASI score were selected to establish the nomogram for nail involvement. AUROC (0.745; 95% CI: 0.725-0.765) indicated the satisfactory discriminative ability of the nomogram. The calibration curve showed favorable consistency, and the DCA showed the good clinical utility of the nomogram.
A predictive nomogram with good clinical utility was developed to assist clinicians in evaluating the risk of nail involvement in psoriasis patients.
指甲受累对银屑病患者有巨大影响。早期发现和及时干预银屑病性指甲损伤很有必要。
从银屑病随访研究数据库中招募了2020年6月至2021年9月期间确诊为银屑病的4290例患者。其中，根据纳入和排除标准选择了3920例患者，分为指甲受累组（n = 929）和非指甲受累组（n = 2991）。进行单因素和多因素逻辑回归分析以确定列线图中指甲受累的预测因素。使用校准图、受试者操作特征（ROC）曲线和决策曲线分析（DCA）来评估列线图的判别能力、校准能力和临床实用性。
选择性别、发病年龄、病程、吸烟、药物过敏史、合并症、银屑病亚型、头皮受累、掌跖受累、生殖器受累和银屑病面积和严重程度指数（PASI）评分来建立指甲受累的列线图。曲线下面积（AUROC）（0.745；95%可信区间：0.725 - 0.765）表明列线图具有令人满意的判别能力。校准曲线显示出良好的一致性，DCA显示列线图具有良好的临床实用性。
开发了一种具有良好临床实用性的预测列线图，以协助临床医生评估银屑病患者指甲受累的风险。
